Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Republic of Korea.
Laboratory of Ocular Regenerative Medicine and Immunology, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
Sci Rep. 2020 Mar 16;10(1):4763. doi: 10.1038/s41598-020-61822-5.
Effects of chemical injuries on the cornea and limbus have been widely studied; however, little is known about glaucoma after ocular chemical injuries. We herein investigated the incidence, risk factors, and outcome of glaucoma in patients with ocular chemical burns. Medical records were reviewed of patients who visited our clinic for chemical injuries to the ocular surface. Patients were divided into glaucoma and non-glaucoma groups based on high intraocular pressure (IOP) readings. Clinical characteristics, treatment method, and therapeutic and visual outcomes were compared between the two groups. Of 29 patients (40 eyes), 9 patients (15 eyes, 37.5%) were diagnosed with glaucoma at 2.64 ± 2.92 months after injury. Factors associated with glaucoma included male gender (p = 0.0114), bilateral ocular involvement (p = 0.0478), severe ocular surface involvement (Dua grades IV-VI, p = 0.0180), poor initial visual acuity (p = 0.0136), high initial IOP (p < 0.0001), pupil involvement at initial examination (p = 0.0051), and the need for amniotic membrane transplantation in the acute stage (p = 0.0079). At final follow-up, IOP was uncontrolled in 3 eyes (20.0%), and visual acuity was worse in the glaucoma group than in the non-glaucoma group (logMAR 2.94 ± 1.86 vs 0.34 ± 0.69, p < 0.0001). These findings suggest that careful evaluation and intensive treatment for glaucoma are essential in patients with severe ocular burns.
眼部化学伤对角膜和缘的影响已得到广泛研究,但对于眼化学伤后青光眼的认识仍较少。本研究旨在探讨眼化学烧伤患者青光眼的发生率、危险因素和转归。
回顾性分析在我院就诊的眼化学伤患者的病历资料。根据高眼压(IOP)读数将患者分为青光眼组和非青光眼组。比较两组患者的临床特征、治疗方法以及治疗和视力转归。
在 29 例(40 眼)患者中,9 例(15 眼,37.5%)在损伤后 2.64±2.92 个月时被诊断为青光眼。与青光眼相关的因素包括男性(p=0.0114)、双眼受累(p=0.0478)、严重的眼表受累(Dua 分级 IV-VI,p=0.0180)、初始视力较差(p=0.0136)、初始 IOP 较高(p<0.0001)、初始检查时瞳孔受累(p=0.0051)以及急性期行羊膜移植(p=0.0079)。末次随访时,3 眼(20.0%)眼压控制不佳,青光眼组的视力较非青光眼组差(logMAR 2.94±1.86 比 0.34±0.69,p<0.0001)。
这些发现表明,对于严重眼烧伤患者,仔细评估和强化治疗青光眼至关重要。